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Paranoid Personality Disorder (PPD)

Introduction

Paranoid personality disorder is a serious mental health condition in which the sufferer has a chronic mistrust of friends, strangers and authority figures.

PPD sufferers often have a heightened sensitivity to the actions and words of others, and often combine confirmation bias with dissociation to form a world view which confirms their belief that they are in imminent danger.

Because of their world view, people who suffer from PPD have a tendency to isolate themselves and may become hostile to people who threaten this isolation, such as family members, partners and friends.


PPD Characteristics & Traits

Acting In - Acting In behavior refers to a subset of personality disorder traits that are more self-destructive than outwardly-destructive.

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Cognitive Dissonance - A psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. People who suffer from personality disorders often experience cognitive dissonance when they are confronted with evidence that their actions have hurt others or have contradicted their stated morals.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - When you feel sadder than you think you should, for longer than you think you should - but still can't seem to break out of it - that's depression. People who suffer from personality disorders are often also diagnosed with depression resulting from mistreatment at the hands of others, low self-worth and the results of their own poor choices.

Dissociation- Dissociation is a psychological term used to describe a mental departure from reality.

Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

FOG - Fear, Obligation & Guilt - The acronym FOG, for Fear, Obligation and Guilt, was first coined by Susan Forward & Donna Frazier in Emotional Blackmail and describes feelings that a person often has when in a relationship with someone who suffers from a personality disorder. Our website, Out of the FOG, is named after this acronym.

Gaslighting - The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.

Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Lack of Boundaries - A lack of boundaries is often at the root of long-term abusive relationships. Lack of boundaries means the absence of rules, limits and guidelines for acceptable behavior. Inconsistent or intermittent reinforcement of consequences for inappropriate behavior is common among both abusers and abuse victims.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Learned Helplessness- Learned helplessness is when a person begins to believe that they have no control over a situation, even when they do.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Magical Thinking - Looking for supernatural connections between external events and one’s own thoughts, words and actions.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Silent Treatment - A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Thought Policing - A process of interrogation or attempt to control another individual's thoughts or feelings.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - A tendency to focus on a single concern, while neglecting or ignoring other important priorities.


Paranoid Personality Disorder (PPD) - The DSM Criteria

Paranoid Personality Disorder (PPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

Paranoid Personality Disorder (PPD) is defined as:

a pervasive distrust and suspicion of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  4. Reads benign remarks or events as threatening or demeaning.
  5. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights.
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

The traits, behaviors and characteristics:

  1. Do not occur exclusively during the course of a mood disorder accompanied by psychotic features nor other psychotic disorders.
  2. Are not due to the direct physiological effects of a general medical condition.

A formal diagnosis of PPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with PPD may exhibit all 7. Most will exhibit only a few.

Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person PPD.

Understanding the clinical criteria for Paranoid Personality Disorder (PPD) is helpful but learning how to cope with having a loved-one who suffers from PPD is quite different.

One of the most effective ways we have found to deal with that is to get support from people who understand what it feels like to be in a relationship or be a family member of someone who suffers from a personality disorder and have learned how to cope. You can find people like that at our Support Forum.


PPD Causes and Treatment

The precise cause of PPD is unknown. PPD has been linked to schizophrenia in some studies which has led to a theory that its causes may be genetic in nature. Some nurturing element has also been associated to PPD.

Because of the nature of the disorder, it is often very difficult to persuade people who suffer from paranoid personality disorder to trust a mental health professional. In general, a combined regime of antidepressant or antipsychotic medication and psychotherapy are prescribed.


Movies Portraying Paranoid Personality Disorder Traits

The Caine Mutiny - The Caine Mutiny is a 1954 World War II drama which portrays the paranoia of a fictitious naval officer Phillip Queeg, played by Humphrey Bogart.

The Treasure of the Sierra Madre - The Treasure of the Sierra Madre tells the story of 3 American prospectors searching for gold in Mexico. One of the prospectors, Fred Dobbs, played by Humphrey Bogart, exhibits paranoid traits.


PPD Support Groups & Links:

Out of the FOG Support Forum - Visit the support forum here at Out of the FOG.

Psychforums PPD forum - Psychforums Site.


For More Information & Support...

If you suspect you may have a family member or loved-one who suffers from a personality disorder, we encourage you to learn all you can and surround yourself with support as you learn how to cope.

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